A collection of work by Nic Horton

It may not make the news every day, but welfare fraud is a serious problem – not only because of its volume, but also because of its impact on the truly needy. On the front end of welfare enrollment, lax eligibility verification by states has resulted in an unknown number of individuals signing up for benefits they don’t actually qualify for. And within the program itself, infrequent and insufficient monitoring has resulted in potentially millions of enrollees staying in the program longer than they should.

By a vote of 55 to 32, the Arkansas House voted yesterday to pass HB1465. The bill, sponsored by Republican State Rep. Josh Miller, would require the Department of Human Services to ask the Trump administration for an enrollment freeze in the state’s out-of-control Medicaid expansion program. No existing enrollees would be removed but no new applications would be accepted. The bill provides what could be a blueprint for lawmakers in D.C. who are looking for options to unwind ObamaCare.

HB1465 flew through the Arkansas House Public Health & Welfare committee earlier this week by a vote of 13-6, even garnering the support of some previous Medicaid expansion supporters, including Committee Chairman Rep. Jeff Wardlaw. Wardlaw, who voted for the initial expansion in 2013, was a Democrat at the time, but switched parties last November, just weeks after the election.

And Wardlaw is not alone. Yesterday, on the floor of the House, multiple members of both parties who have previously supported Medicaid expansion voted in favor of Miller’s commonsense proposal. Many of them voted for the original expansion proposal back in 2013.

The progression of HB1465 through the legislature is demonstrative of the political realignment happening not just in Arkansas but in expansion states across the country. Continue reading →

As the dust of the Obama administration continues to settle, a trend is growing across the country: State leaders are stepping up to tackle big problems in their welfare systems. Specifically, states are moving away from policies that promote long-term dependency and towards reforms that are pro-work and pro-independence.

It’s officially 2017. A new year, full of new beginnings and opportunities. But for taxpayers and the truly vulnerable in ObamaCare expansion states, it’s the continuation (and acceleration) of a nightmare. As of January 1, states are on the hook for 5 percent of the expansion’s costs. And with more enrollees than states expected to ever enroll, this fiscal nightmare will be even worse than expected, putting taxpayers and the truly needy at even greater risk. Continue reading →

When Arkansas legislators and then-Governor Mike Beebe expanded Medicaid to able-bodied adults through ObamaCare, supporters claimed their plan was something other states were closely watching and, before it was even implemented, was serving as a national model. What unfolded, however, was a fiscal and moral disaster that no other state dares to fully replicate.

Experts have long raised questions about the budget gimmickry involved in the Obama administration’s approval of Arkansas’ Obamacare expansion waiver. The Government Accountability Office even warned that the administration and Arkansas cooked the books to secure the waiver. But now, the state’s own evaluation of the program – spearheaded by one of the program’s architects – shows just how badly Arkansas got it wrong. Continue reading →

Policymakers in the Land of Lincoln have some important work to do this year to preserve limited state resources for the truly vulnerable. Stopping the enrollment of able-bodied adults in Illinois’ Medicaid expansion program, and instituting work requirements for able-bodied adults in Medicaid are necessary to safeguard the program for Illinoisans most in need of services.

A Medicaid enrollment freeze waiver can preserve resources for truly needy Illinoisans
To stop Medicaid expansion enrollment, Illinois policymakers should ask the Trump administration for an enrollment freeze waiver. The program is devouring state tax dollars that could go to help Illinois’ truly needy residents, including the 18,000-plus Illinoisans on Medicaid’s Prioritization for Urgency of Need for Services waiting list. An enrollment freeze waiver would allow state officials to stop the hemorrhaging of Medicaid dollars and begin to immediately prioritize truly vulnerable Illinoisans once again.

Medicaid work requirements can prevent the safety net from becoming a poverty trap
But that’s just the beginning of what Illinois officials must do to reform the state’s overgrown and unsustainable Medicaid system. The state should also request a waiver to institute work requirements for all able-bodied adults in Medicaid. Medicaid’s safety net has become a web that traps too many Illinoisans in dependency. But with the requirements in place, the truly vulnerable and taxpayers will find much-needed relief. Equally important, enrollees will be better able to transition to self-sufficiency.

Currently, Illinois’ Medicaid program is operating as a welfare trap – a system that encourages individuals to remain in dependency indefinitely and penalizes them if they try to leave. There’s perhaps no better proof of this phenomenon than the number of Illinoisans who are in the Medicaid program and not working at all.

According to the most recent data from the U.S. Census Bureau, less than one-third of all able-bodied, working-age Medicaid enrollees in Illinois work full time. By contrast, nearly 36 percent don’t work at all.

In addition, according to data from the Department of Healthcare and Family Services, nearly 54 percent of able-bodied adult enrollees in the Medicaid expansion reported no income at all in 2015. Continue reading →

Thankfully, simple, tested and effective policy solutions exist to the challenges facing the state. By freezing enrollment in its Medicaid expansion program, Illinois can immediately begin protecting resources for its truly vulnerable citizens and help Illinoisans currently trapped in welfare get back on the path to independence. In addition, lawmakers would immediately provide much-needed relief to overburdened state taxpayers.

Enrollment freezes are simple: Rather than pulling the plug on the expansion program overnight, the state would allow current enrollees to stay for the time being, but would stop enrolling new members. This allows lawmakers to gradually wind down the program over time, but immediately free up resources for the truly vulnerable.

During the 2016 legislative session, there was a strong push to expand Oklahoma’s Medicaid program to obtain funding from the Affordable Care Act. Ultimately, lawmakers declined to take that step. It’s proving to be a wise decision…

A recent report by the Foundation for Government Accountability notes that expansion enrollment exceeded projections by 322 percent in California, 276 percent in New York, 134 percent in Kentucky, 90 percent in Illinois, 60 percent in Ohio and 51 percent in Arkansas.

That means the cost of the 10 percent state share for Medicaid expansion will be commensurately higher as well. And federal data shows that Medicaid expansion spending was 49 percent higher per enrollee in 2015 than what was predicted when the law passed in 2010.

At the same time, Medicaid expansion isn’t generating the savings supporters promised, such as lowering the use of emergency rooms for routine care.